6737 - Laserfiche WebLink

Home Browse Search

r ,, • APPLICATION FOR SANITATION PERMIT Permit No. (Complete in Duplicate) 9� Date Issued Applica;-ion is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549, W. JOB ADDRESSANDLOCATIO __2_ 7-)� 3 _`� " _1Q� '__0'u --------_•_._... __ _- .-_ � ` Owners ------ --------------------------------------------- ---------,-- ---------------- Address ----- Address------- ------ ._3 ....--- .- -- --------------------------------------- e �iJG Contractor's Name------------- �------ —411 1--------------------•--= --•--- Phone.. Installation will serve: Residence Apartment House,❑ Commercial ❑ , Trailer Court ❑ Motel ❑ Other ❑ f Number of living units: "( uml�e r of bedrooms -. Number of baths ._ -- Lot size _________ _ _____________________ ___________________ Wafer Supply: Public syst' ❑ `Community system ❑ Private Depth to Water Table _34 ft. r � Character of soil to a depth:of-3 feet: Sand ❑ Gravel Sandyi Loam ❑ -Clay:-Xborri E] Clay E] Adobe�ardpan L]_ t," i Previous Application Made: Yds ! No ,New,Construction: Yes [ N ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank -or cesspof permitted if public sewer is available within 200ifeet.) I . 1k Septic Tan Distance from nearest well_q 1 Distance from foundation__ --- - ---._.Material at...... �No. of t r4artments-------------�------.--Size__S4_�6 _�+�_v'"_Liquid depth--- f„�,�-------Capacity----g'ra--y--- Disposal Field: Distance fromnearest well__.7A--------Distance from foundation__/d-_________.Distance to nearest lot line__,4_*4'____ • % usnber,�oAinbs_______I--------.__- -- -<4=L-en k of each line-.-- � Widfh of french...... p Seepage t: (rf7istanc to nearest well_.©_________Distance from material___._: __ ::_` __Total length___-._ ________________________ ------------- Type or .filter'rna't�ria t'_ � ___.____De Depth of filte faun ation__3---- ...Distance to nearest lot line__��__�___ Number1of pits- - --------------Lining materialC�•__�/_Size: Diameter,----3e3---------- _Depth-- _��_ - - Cesspool: Distance from nearest weil-----------------Distance from foundation------------------__Lining material___.___._.._____._._________________- Q m � -----------------❑ Size: Diaeter---------- Depth -,--_--- - _-�__Liquid Capacity----------------------------gals. C Privy: Distance from nearest re %we�l_______________________________________-----------Dis"tance from n earestibuilding________.______________..__---_-____..- ❑ Distance to neast lot line----------------------------------------------------------------------- ------------------------------ Remodeling and/or repairing (describe):-----------------------------------------------------------------------•-•----•----------------• ------------------------------------------------------- -----------------------------------------------------------•--------------•-•-••-------•--------•--------•-----••-------------------------------•---------------- -----•---------•--------------------------------------- I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin County ordinances, State laws-,-end rules and regulations of the San Joaquin Local Health District. --------------------- _ _-__ w er and/or Cont ctor) a sY� � � .�_.._ (Title ---- --------------------------- (Plot plan, showing size of lot, location of system in relation ells, buildings, etc., can be placed on reverse side). FOR DEPARTMENT USE ONLY APPLICATION ACCEPTED BY ----------- ------------- ----------------- ------ --------------------------------------.. DATE-------•---------- ------------------------------- REVIEWED BY .. - DATE - i7--1--------------------------------------------------- BUILDING PERMIT ISSUED------------------------------------------------------------------------------------------------------ DATE------A-------------- ----------------------- •---•----- Alterations and/or recommendations:....----------------------------------------------------------------------------------------- -F . ---•------------------------ --- ------------------------- - - -- ---------------------------- ---•----- -----•------------------- --------------------------------------- �.----- -------------- ------ -------------------------------- -- --- ----- --- -------------------- = ---------------------- ---------------------- ------—-------------------------------------------------------------- ---------------------------------------------------------------------------- FINAL INSPECTION BY:---------- -------------------------------------------------- Date--=---- ---- z '._. S..--- - ----------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 130 South American Street 300 West Oak Street 132 Sycamore Street 814 North "C" Street Stockton, California Lodi, California Manteca, California Tracy, California ES-9-2M ; Revised W-2100